Heroin use among clients receiving methadone treatment in Dar es Salaam Tanzania: a qualitative study

Background: Simultaneous heroin use among methadone-maintained clients is a recognized phenomenon worldwide. Tanzania is the first sub-Saharan African country to offer methadone treatment. This study explored reasons for heroin use among clients on methadone treatment clinics in Dar es Salaam, Tanzania. Methods: This was exploratory cross-sectional study. Purposive sampling was used to select ten study participants. In in-depth interview guide was used to collect data. The interviews were conducted in Kiswahili and lasted for about sixty minutes. Audio-recordings of the interviews were transcribed verbatim and translated into English. Transcribed data was analysed and subjected to thematic analysis with the help of Nvivo 12 software. Results: Many reasons were mentioned for concurrent use of heroin and methadone among clients on methadone treatment. Some of the mentioned reasons were inadequate methadone dose, treatment, healthcare providers’ attitudes, and healthcare provision environment, lack of family support, peer influence homeless and easy availability of heroin. Conclusions: Different measures should be taken by methadone programs and stakeholders to overcome concurrent use of heroin and methadone among clients receiving methadone treatment.

Exploring the teaching strategies of medical terminology / 中华医学教育探索杂志

This paper explores the teaching methods of medical English terminology from three aspects: vertical and horizontal learning thinking style, DAR(division, analysis and reading) three-step terminology reading process, and diverse comparative vocabulary learning methods. In the teaching, students are guided to establish a framework of terminology learning in a macroscopic level, to interpret medical step by step and to use some of the comparative learning methods in ordinary English vocabulary learning to consolidate the learning and memory of medical terms. Through these three aspects of teaching guidance, students are helped to weave their medical terminology learning framework, to build a terminology learning library, and to turn terminology learning and application into a lasting and effective learning process.

Orientaciones filosóficas en la intervención fonoaudiológica de voz. El desafío actual de dar el alta / Philosophical orientations in voice therapy. The current challenge of discharge

El presente artículo corresponde a una reflexión sobre las orientaciones filosóficas en la terapia vocal actual. Cuando existe alguna alteración o trastorno vocal, se habla comunmente de un desequilibrio entre los subsistemas involucrados en el proceso fonatorio, es decir, fuelle (sistema respiratorio), fuente (pliegues vocales) y filtro (tracto vocal). Si no hay un correcto balance, entonces el sistema no tiene un correcto funcionamiento y pueden aparecer síntomas como ronquera, sensación de cuerpo extraño, prurito, fatiga vocal o bien disfonía o incluso afonía. Como con-secuencia de estas dificultades, se generan compensaciones que durante el proceso de la intervención fonoaudiológica el profesional debe volver a "equilibrar". Para lograr este objetivo, se desarrollan y analizan las diversas herramientas que entregan las filosofías de pensamiento a lo largo de la historia de la rehabilitación vocal, don-de se encuentran la orientación higiénica, psicológica, sintomatológica, fisiológica y ecléctica. En este mismo sentido, el profesional debe buscar lo que percibe como más idóneo para cada paciente o grupo a intervenir, centrado en mejorar la calidad vocal y las necesidades actuales de estos, basándose en el contexto mundial actual, con el objetivo de lograr un buen proceso de entrenamiento o rehabilitación y final-mente lograr el alta.

The present article corresponds to a reflection about the philosophical orientations in the current vocal therapy. When there are some vocal alterations or disorders, we usually talk about an imbalance between the sub-sysmtems involved in the fonatory process, which are bellows (respiratory system), source (vocal folds) and filter (vocal tract). When there is not a correct balance, the system does not work properly and as a consequence, it is possible to experiment symptoms such as hoarseness, foreign body sensation, pruritus, vocal fatigue, dysphonia or even aphonia. As a result of these difficulties, it is possible to generate compensations through the intervention of speech therapy. By virtue of this therapy the professional must 'balance'. In order to achieve this, it is necessary to develop and analyze the different tools that philoso-phical studies offer through the history of vocal rehabilitation. Some of these tools are hygienic orientation, psychological, symptomatological, physiological and eclec-tic. Thinking on that, the professional must search what it is most suitable for every patient or group of people that he/she will be working with. This must be focus on improving vocal quality and the actual necessities of the patient, based on the current global context. The final purpose of the professional is to achieve a good and healthy process of training and/or rehabilitation to accomplish medical discharge.

Current LC-MS-based strategies for characterization and quantification of antibody-drug conjugates / 药物分析学报

The past few years have witnessed enormous progresses in the development of antibody-drug conju-gates (ADCs). Consequently, comprehensive analysis of ADCs in biological systems is critical in sup-porting discovery, development and evaluation of these agents. Liquid chromatography-mass spectrometry (LC-MS) has emerged as a promising and versatile tool for ADC analysis across a wide range of scenarios, owing to its multiplexing ability, rapid method development, as well as the capability of analyzing a variety of targets ranging from small-molecule payloads to the intact protein with a high, molecular resolution. However, despite this tremendous potential, challenges persist due to the high complexity in both the ADC molecules and the related biological systems. This review summarizes the up-to-date LC-MS-based strategies in ADC analysis and discusses the challenges and opportunities in this rapidly-evolving field.

Magnitude of repair failure and associated factors among women undergone obstetric fistula repair in Bahir Dar Hamlin Fistula Center, Amhara Region, Northwest Ethiopia

Background:Globally, preventionand repair of obstetric fistula remains a challenge, Ethiopia is one of the high-burden countries that constitute to the high fistula belt in the world. Methods:Cross sectional study was conducted from1st April 2018 to 1stMay2018 on women who had undergone obstetric fistula repair from 1stJanuary 2013 to 30th December 2017. Systematicsampling technique was applied to select a total of 385 study participants. Data were collected by reviewing clients’ cards using pre-tested questionnaire. Binary and multivariate logistic regression was conducted using SPSS version 21.0 statistical software.Results:The magnitude of fistula repair failure was 35.3%. Women weighing <50 kgs (AOR=3.43,95% CI: 1.89, 6.23), home delivery (AOR=2.40, 95%CI: 1.38, 4.18), labour for >2 days (AOR=3.22, 95%CI: 1.75,5.91), >3 cm width of fistula (AOR=2.30, 95%CI:1.27, 4.17), grade three fistula (AOR=3.26, 95%CI: 1.29, 8.27), grade four fistula (AOR=9.76, 95%CI: 3.71, 25.67), complete destruction of bladder neck (AOR=2.70, 95%CI: 1.07, 6.66) and post operation infection (AOR=2.98, 95%CI: 1.56, 5.70) were associated factors with fistula repair failure at p value <0.05.Conclusions:Caution should be taken for obstetric fistula repairing women who presented with less than 50 kg, home delivered, greater than two days labour, greater than 3 cm width of fistula, grade 3 and 4 fistulas, complete destruction of the bladder neck and post-operative infection.

Impacto de diferentes modalidades de evaluación en el promedio de notas de estudiantes de Medicina: un estudio de intervención no aleatorizado / Impact of different types of evaluation on the average grade of medicine students: a non-randomized interventional study

Introducción: en el proceso de enseñanza-aprendizaje existen múltiples conflictos al momento de seleccionar el tipo de evaluación que debería aplicarse a estudiantes de Medicina. Nuestro objetivo es comparar diferencias en la media de notas de tres modalidades de examen (oral, escrito para desarrollar y preguntas de opción múltiple) para así determinar cómo estas podrían afectar el desempeño de los estudiantes de Medicina en el campo de la Farmacología. Material y métodos: estudio cuasi experimental con una intervención no aleatorizada en una muestra por conveniencia de estudiantes de Medicina. A fin de evaluar diferencias en la media de notas se hizo un análisis ANOVA para muestras pareadas y luego los correspondientes tests de T para muestras pareadas. Resultados: enrolamos inicialmente a 36 estudiantes; 7 fueron excluidos (4 por ausencia y 3 por abandono), y se obtuvieron 29 participantes. La media de notas del examen oral y la de preguntas de opción múltiple fueron ambas significativamente superiores a la del examen escrito para desarrollar (oral vs. escrito: diferencia 1,8 puntos; IC 95% 0,8 a 2,7; p < 0,01; opción múltiple vs. escrito: diferencia 2,1 puntos; IC 95% 1,4 a 2,9; p < 0,01). No hubo diferencias estadísticamente significativas entre las notas medias del examen oral y del examen de preguntas de opción múltiple (p = 0,37). Conclusión: los estudiantes de Medicina obtienen peores notas en el examen escrito para desarrollar en Farmacología, en relación con los exámenes oral y de preguntas de opción múltiple. Esto posiblemente se asocie al hecho de que aquella modalidad es menos frecuentemente empleada en la carrera de Medicina. (AU)

Introduction: in the teaching-learning process, there are many problems in the selection of the most suitable type of exam for evaluating medical students. Our target was to compare differences in the average grade of medical students upon taking three different types of exam (oral, written, and multiple-choice questions) to determine how these different types of exam may affect the performance of medical students in the area of Pharmacology. Material and methods: we conducted a quasi experimental study by applying a non-randomized intervention to a convenience sample of medical students. To evaluate differences in the average grades among three groups, an ANOVA analysis was applied followed by paired T-tests. Results: we initially enrolled 36 students; 7 were excluded (4 were absent and 3 abandoned the intervention), arriving at a total sum of 29 participants. The average grades of the oral exam and multiple-choice questions were both significantly higher than the written exam (oral vs. written: difference 1.8 points; 95%CI 0.8 to 2.7, p < 0.01; multiple-choice vs. written: difference 2.1 points, 95%CI 1.4 to 2.9, p < 0.01). There were no significant differences between the average grades on the oral exam and the multiple-choice exam (p = 0.37). Conclusion: medical students have worse grades on written exams in Pharmacology, as compared to oral and multiple-choice exams. This could possibly be associated with the fact that this type of exam is less frequently applied in Medical School. (AU)

Prevalence and Species Identification of Ixodidea Tick on Bovine in and Around Bahirda Town West Gojam, North West Ethiopia

A cross- sectional study was conducted in and around Bahir Dar, from November, 2016 to April, 2017 to estimate the prevalence of major ixodidea ticks on bovine and to identify ticks on the species level. Study animals were selected randomly. Out of the total of 384 cattle examined, 157(40.9 %) were found to be infested. About 822 adult ticks were collected both sides of animal body parts, then preserved with 70% alcohol within universal bottle and were identified to species level by using stereo-microscope. From the total ticks collected, four genera and species namely; Amblyomma varigatum, Boophilus decoloratus, Rhipicephalus evertsis and Hyalomma marginatu were identified and account for 45.3, 22.9, 15.8 and 17.03%, respectively. From different variables (sex, age, breed and body condition), body condition and predilection sites were statistically significant with tick infestation (p< 0.05). The prevalence of tick infestation was found highest in poor body condition animals (16.9%) while in medium and good body condition, it was found (14.58%) and (9.36%), respectively. It has also been evident that the favorable predilection sites of A.varigatum ticks were preferred scrotum/udder and pernial region. B.decoloratus preferred dewlap, scrotum/udder and Rh.evertis had a strong affinity on anus, dewlap and tail tip. H.marginatum the perineum region and dewlaps were its hiding sites. From this study we can make a conclusion that the prevalent ticks could also be responsible for transmission of tick borne diseases in addition to their physical damage

Factors Related to Deaths of under 5 Years Old Children in Dar Alsalam Area-Khartoum-Sudan

Aims: This study is done to identify factors affecting under five mortality in Dar Alsalam area, Khartoum.Study Design:This is a community based cross-sectional study.Place and Duration of Study:The study was carried out in block 25 in Dar Alsalam area in Khartoum State during March-April 2012.Methodology: A total of 240 women in reproductive age who had an experienceof child death were interviewed. The data was collected by semi-final medical students using structured questionnaire. Two stage cluster sampling was used to select the households. Data was summarized using descriptive statistics and logistic regression analysis was carried out to identify factors associated with under-five mortality.Results: Age of 156 (65%) of the deceased children was less than one year, while the age of 84 (35%) was between one and five years. The age of (25%) of the motherat the time of their child birth was below 18 years. The majority of the mothers (70.8%) were illiterate, 74.2% were working and 80% were married. Of the children 51.7 were males and for 74.2% of them the birth interval was less than 2 years. Only 16.7% were breast fed for more than two years while the rest (83.3%) were breast fed up to 2years. Only 34.2% of the deceased children had completed their vaccination, and 68.3% had been admitted to hospital more than once before death.Half of the families have piped water in their houses, in 75.8% of the houses there are pit latrines andin68.3% there is electricity supply. Logistic regression analysis identified incomplete vaccination, not employed mothers and having no latrines in the house as the factors related to the death of children between 1-5 years than those below one year.Conclusion: Under-five mortality in low socioeconomic areas is associated with Low family income, mother’s illiteracy, early marriage and absence of latrines in the houses.

Between dying and existing: from the failure of self eroticism inscription to the problems of the passage from girl to woman in anorexia / Entre morrer e existir: da falha na inscrição do autoerotismo aos impasses da passagem de menina a mulher na anorexia

O presente artigo tem como objetivo compreender a manifestação da anorexia em mulheres. Partiremos da investigação da relação entre a falha na inscrição do autoerotismo e a manifestação da anorexia. Seguiremos para a averiguação de qual é a especificidade do funcionamento psíquico feminino que, para além dos componentes sociais associados às exigências estéticas, contribui para a manifestação dessa problemática no campo do feminino e quais são os impasses da passagem de menina a mulher que ela revela. Finalmente, visaremos compreender o que faz com que as anoréxicas cheguem a ponto de se darem a morrer.

The present article aims to comprehend the manifestation of anorexia in women. We will depart from the investigation of the connection between the failure of self eroticism inscription and the manifestation of anorexia. Then, we will verify the specificity of female psychic functioning that, beyond social esthetics demanding, contributes to the manifestation of anorexia in women and the problems from the passage from girl to woman that it reveals. Finally, we will intend to understand what makes the anorexics get to the point of giving themselves to death.

Estudio TAMARA II. Tabaquismo en médicos de la República Argentina II / The tamara ii trial. smoking among physicians in argentina

background: Smoking is the leading cause of preventable morbidity and death. It is important to know the characteristics of smoking habits among physicians and their attitude toward patients who smoke. Objective: The aim of this study is to investigate the prevalence of smoking among physicians in Argentina, the factors associated with tobacco consumption and their attitude toward their patients who smoke. Methods: An observational cross- sectional study was performed between June and December 2013 in Argentine physicians of dif-ferent specialties. Using a structured survey, the following variables were analyzed: associated cardiovascular risk factors, charac-teristics of tobacco consumption, smoking cessation training and the attitude toward the patient who smokes. results: 3,033 physicians were surveyed, ; 57% were men, and mean age was 41.3±12 years; 19.7% were current smokers and 21.7% were former smokers. The probability of being a smoker was higher among surgeons (OR 1.29) or physicians working at the emergency room (OR 1.41). Undergraduate and postgraduate tobacco cessation training was achieved by 36.6% and 40.8% of physicians, respectively. Young physicians, clinical specialties or private practice were associated with higher level of training. Tobacco cessation counseling was more frequent in physicians with higher level of training than physicians who smoked or surgeons. Former smokers presented higher prevalence of risk factors and cardiovascular events. Family history of smoking habit was more common in former smokers and current smokers. Conclusions: The prevalence of smoking among Argentine physicians is high. Different factors are involved in the probability of smoking, tobacco cessation training or the possibility of medical counseling. Higher level of training in smoking cessation must be provided.

Prevalence and determinants of work related injuries among small and medium scale industry workers in Bahir Dar Town, north west Ethiopia

OBJECTIVES: To assess the prevalence and determinants of work-related injuries among small and medium scale industrial workers in Bahir Dar town, northwest Ethiopia. METHOD: Cross sectional comparative study design was used. Purposive sampling method was used to choose the specific Kebele 14 of the study area, for its relatively high number of industries. The study units were stratified into small and medium scale industries. All workers who were available at the time of interview were included in the study. A pre-tested questionnaire was used to collect data. Data was analyzed using SPSS for windows 16.0. RESULT: A total of 328 and 655 workers from small and medium-scale industries respectively participated in the study. Seven hundred sixty nine (78.2%) were males. Three hundred thirty six workers (34.2%) reported that they had experienced work-related injuries. Sex, monthly salary, age, work experience and use of personal protective equipment were found to be different in the small and medium industries (P < 0.05). CONCLUSION: There was a high prevalence of work related injuries. Sociodemographic, socioeconomic, personal work behavior and the working environment have contributed for the injuries. Work-related injuries are assumed to be preventable with the provision of occupational health programs in workplaces. Thus it is recommended that the owners of industries need to focus on training and installing safer work environment and Further studies with large-scale coverage and prospective study designs are warranted.

Sero-prevalence and associated risk factors of Toxoplasma gondii infection among pregnant women attending antenatal care at Felege Hiwot Referral Hospital, northwest Ethiopia

OBJECTIVE@#To determine the prevalence of toxoplasmosis and to assess the possible risk factors associated with the infection among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, Bahir Dar town, northwest Ethiopia.@*METHODS@#A hospital based cross-sectional study was designed to determine the prevalence of toxoplasmosis among pregnant women. Three hundred eighty four serum samples were collected from November 2013 to January 2014. Data on socio-demographic and predisposing factors were collected from each study participant with simple random sampling technique. The serum samples were examined for anti-Toxoplasma gondii (T. gondii) antibodies using latex agglutination test.@*RESULTS@#The overall seroprevalence of T. gondii among the pregnant women was 18.5%. All of T. gondii positive cases found to be positive only for IgG antibody. Significant association was observed between seroprevalence and presence of domestic cats [AOR = 2.85, 95% CI: 1.66-4.90, P = 0.000], consumption of raw or undercooked meat [AOR = 1.98, 95% CI: 1.15-2.43, P = 0.014] and history of abortion [AOR = 2.47, 95% CI: 1.40-4.34, P = 0.002]. No significant association was observed between seroprevalence and socio-demographic characters, gestational age, gravidity, consumption of raw vegetable, and blood transfusion.@*CONCLUSIONS@#The seroprevalence of toxoplasmosis among pregnant women in Bahir Dar town was relatively high. Presence of domestic cats at home and consumption of raw or undercooked meat were identified as main risk factors for T. gondii infection. Therefore, health education towards avoiding eating raw or undercooked meat and avoiding contact with cats are recommended for prevention of miscarriage or defects during pregnancy.

Sero-prevalence and associated risk factors of Toxoplasma gondii infection among pregnant women attending antenatal care at Felege Hiwot Referral Hospital, northwest Ethiopia

Objective: To determine the prevalence of toxoplasmosis and to assess the possible risk factors associated with the infection among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, Bahir Dar town, northwest Ethiopia. Methods: A hospital based cross-sectional study was designed to determine the prevalence of toxoplasmosis among pregnant women. Three hundred eighty four serum samples were collected from November 2013 to January 2014. Data on socio-demographic and predisposing factors were collected from each study participant with simple random sampling technique. The serum samples were examined for anti- Toxoplasma gondii (T. gondii) antibodies using latex agglutination test. Results: The overall seroprevalence of T. gondii among the pregnant women was 18.5%. All of T. gondii positive cases found to be positive only for IgG antibody. Significant association was observed between seroprevalence and presence of domestic cats [AOR = 2.85, 95% CI: 1.66-4.90, P = 0.000], consumption of raw or undercooked meat [AOR = 1.98, 95% CI: 1.15-2.43, P = 0.014] and history of abortion [AOR = 2.47, 95% CI: 1.40-4.34, P = 0.002]. No significant association was observed between seroprevalence and socio-demographic characters, gestational age, gravidity, consumption of raw vegetable, and blood transfusion. Conclusions: The seroprevalence of toxoplasmosis among pregnant women in Bahir Dar town was relatively high. Presence of domestic cats at home and consumption of raw or undercooked meat were identified as main risk factors for T. gondii infection. Therefore, health education towards avoiding eating raw or undercooked meat and avoiding contact with cats are recommended for prevention of miscarriage or defects during pregnancy.

Clinical efficacy of Qingyi decoction combined with DAR for the treatment of acute pancreatitis / 中华急诊医学杂志

Objective To explore the clinical efficacy of Qingyi decoction (a preparation of Chinese herbal medicine) combined with DAR (combined use of dexamethasone,anisodamine and rhubarb) for the treatment of acute pancreatitis.Methods A total of 387 eligible patients met the criteria of acute pancreatitis were enrolled from January 2005 to April 2012 for prospective study.All patients,mild acute pancreatitis (MAP) or severe acute pancreatitis (SAP),were divided (random niumber) into four groups,namely conventional therapy (T),DAR therapy (DAR),Qingyi decoction therapy (Q) and Qingyi decoction combined with DAR therapy (Q + DAR).Outcome,fasting time,serum amylase,abdominal pain relief time,pancreatic or peri-pancreatic complications and average hospital-stay were analvzed with SPSS 13.0 statistic software.P ＜ 0.05 was considered statistically significant.Results None of MAP patients died.Of SAP patients,there was no difference in mortality among different groups (P ＞ 0.05).length of fasting time,tine elapsed for abdominal pain relief,time required for normalized serum amylase level and length of hospital stay in MAP patients were significantly shorter than those in SAP patients regardless of different therapies (P ＜ 0.05).Either patients of SAP or MAP treated with Q + DAR or DAR suffered shorter length of time than those treated with T or Q in respect of fasting,abdominal paiu relief,serum amylase level normalization and hospital stay (P ＜ 0.05).For SAP or MAP patients,there was no difference in abdominal pain relief time between receiving DAR and Q + DAR treatment (P ＞ 0.05),but the fasting time in Q + DAR was shorter than that in DAR (P ＜ 0.05).Patients with SAP were more likely to suffer pancreatic or per-pancreatic complications than those with MAP,but there was no difference for SAP or MAP with different treatments.Conclusions DAR or Q + DAR was an alternative to conventional treatment for MAP or SAP,and they were both superior to conventional treatment.And Q + DAR was more advantageous than DAR when fasting time,hospital-stay time and cost were considered.

Relações entre condutividade hidráulica, transmissividade, condutância longitudinal e sólidos totais dissolvidos para o aquífero livre de Caçapava do Sul (RS), Brasil / Relationship among hydraulic conductivity, transmissivity, longitudinal conductance and total dissolved solids for the free aquifer of Caçapava do Sul (RS), Brazil

A água subterrânea é um importante recurso ao abastecimento público, principalmente para comunidades periféricas em grandes cidades ou pequenos municípios, onde a instalação ou prolongamento de sistemas de distribuição são economicamente inviáveis. Estudos voltados à análise da vulnerabilidade de aquíferos são relevantes para subsídio a políticas públicas em saneamento básico e preservação ambiental. Este estudo contou com o cadastro de 23 poços rasos localizados no município de Caçapava do Sul (RS), onde foram realizadas medidas de resistividade elétrica e cargabilidade por meio de geofísica, e medidas diretas de condutividade hidráulica e sólidos totais dissolvidos. A análise estatística dos dados demonstrou diversos graus de correlação entre parâmetros, basicamente condicionados a fatores geológicos como porosidade, permeabilidade e sólidos totais dissolvidos.

Groundwater is an important resource for the public supply, mainly for the attendance of peripheral communities in large cities or small cities, where the installation or prolongation of distribution systems is economically unfeasible. Studies related to the vulnerability analysis in aquifers are important for subsiding public policies in basic sanitation and environmental preservation. This study was supported by the cadaster of 23 shallow wells localized in Caçapava do Sul (RS). Measurements of electric resistivity and chargeability were performed by geophysical methods, direct measures of hydraulic conductivity and total dissolved solids. The data statistics analysis demonstrated several degrees among parameters, conditioned to geological factors as porosity, permeability and total dissolved solids.

Evolución, desarrollo embrionario / Evolution, embyoonic development and psychism / Evolução, desenvolvimento embrionário e psiquismo

El siguiente artículo intenta establecer nexos y relaciones que se dan entre la evolución del homínido prehumano como la base del psiquismo propiamente humano y mostrar cómo los cambios que son hereditariamente transmitidos, han de producirse físicamente en el plasma germinal, pues de las estructuras morfológicas surge el psiquismo propio de la nueva especie. Se trata de un proceso de potencialidades no meramente biológicas sino metafísicas, en las que las estructuras bioquímicas exigirán para su propia viabilidad, el uso de la inteligencia. El psiquismo no es una creación extrínseca, es por el contrario un cumplimiento exigencial intrínseco, determinado desde las estructuras, no es un mero cumplimiento, sino innovación absoluta. Hay pues un florecimiento psicosomático, una psique intelectiva, en la que la acción creadora no sólo no interrumpe el curso de la evolución sino que es el mecanismo que termina de llevarla a cabo. Evolución es dar de sí en potenciación, no es cambiar sino integrar la mutación en un dar de sí como momento intrínseca, formal y estructural de la materia. Así, la vida es una innovación que la sustantividad material da de sí por mera sistematización, por ello decimos que todo lo psíquico es somático y todo lo somático es psíquico. La embriología experimental y la ingeniería genética nos hacen saber que en las primerísimas etapas del desarrollo -cigoto y mórula- no está terminantemente establecida la especificidad del germen, lo más que puede decirse entonces es que el cigoto de la especie humana es un hombre en potencia condicionada, a la cual sólo puede atribuírsele condición humana con la gastrulación y la formación de las hojas blastodérmicas y de modo más explícito con la aparición de la cresta neural. El brotar de la psique humana acontece cuando en el embrión aparece un claro esbozo del sistema nervioso, dicha estructura es la que da lugar a la simbolización, a los modos cerebral izquierdo y cerebral derecho, permite conocer el mundo, hacer la vida y permite todas las actividades específicamente humanas.

The following article tries to establish nexuses and relations that occur between the evolution of the prehuman hominidous one as the base of the properly human psychism and to show how the changes that hereditarily are transmitted, have to physically take place in the germinal plasma, because from the morphologic structures the own psychism of the new species arises. One is a process of potentialities not merely biological but Metaphysical, in which the biochemical structures will demand for their own viability, the use of intelligence. The psychism is not an extrinsic creation, is on the contrary an intrinsic exigencial fulfillment, determined from the structures, is not a mere fulfillment, but absolute innovation. There is a psychosomatic blossoming, one intellect psique, in which the creative action not only does not interrupt the course of the evolution but it is the mechanism that finishes carrying out it. Evolution is to give of himself in potentiation, is not to change but to integrate the mutation in giving of himself like intrinsic, formal and structural moment of the matter. Thus, the life is an innovation that the material sustantivity gives of himself by mere systematization, for that reason tenth that all the psychic one is somatic and all the somatic one is psychic. The experimental embryology and the genetic engineering let us know that in the first stages of the development - zygote and morule- are not established the specificity of the germ, more than it can say then is that the zygote of the human species is a man in conditional power, to which it only can attribute him to human condition with the gastrulation and the formation of the blastodermic leaves and more explicit way with the appearance of the neural crest. Appearing of human psique occurs when in the embryo appears a clear outline of the nervous system, this structure is the one that gives rise to the simbolization, to the left and right cerebral modes, allows to know the world, to make the life and allows all the human specific activities.

O seguinte artigo tenta estabelecer nexos e relações que dão entre a evolução do hominídeo pré-humano como a base do psiquismo propriamente humano e mostrar como as mudanças que são hereditariamente transmitidas, têm que se produzir fisicamente no plasma germinal, pois das estruturas morfológicas surge o psiquismo próprio da nova espécie. Tratase de um processo de potencialidades não meramente biológicas se não metafísicas, nas que as estruturas bioquímicas exigirão para sua própria viabilidade, o uso da inteligência. O psiquismo não é uma criação extrínseca, é pelo contrário um cumprimento intrínseco, determinado desde as estruturas, não é um mero cumprimento, se não inovação absoluta. Há um florescimento psico-somático, uma psique intelectiva, na que a ação criadora não só interrompe o curso da evolução se não que é o mecanismo que termina de levála a cabo. Evolução é dar de si em potencia, não é mudar se não integrar a mutação em um dar de si como momento intrínseco, formal e estrutural da matéria. Assim, a vida é uma inovação que a parte substancial da matéria dá de si por mera sistematização, por isso dissemos que todo o psíquico é somático e todo somático é psíquico. A embriologia experimental e a engenharia genética fazem saber que nas primeiras etapas do desenvolvimento – zigoto e mórula- não está terminantemente estabelecida a o tipo do germe, o máximo que se pode dizer é que o zigoto da espécie humana é um homem em potência condicionada, na qual só pode atribuir condição humana com a gastrulação e a formação das folhas blasto dérmica e de modo mais explícito com a aparição da cresta neural. O brotar da psique humana acontece quando no embrião aparece um claro esboço do sistema nervoso, tal estrutura é a que dá lugar á simbolização, os modos cerebral esquerdo e cerebral direito, permite conhecer o mundo, fazer a vida e permite todas as atividades específicas humanas.

Farmacovigilancia de los Agonistas Adrenérgicos en pacientes de la unidad de cuidados intensivos del hospital "Dr. Miguel Pérez Carreño"

Se realizó un estudio de tipo prospectivo descriptivo en 84 pacientes en quienes se determinaron las reacciones adversas (RAM´s) tras la administración IV de alguno de los siguientes agonistas adrenérgicos: noradrenalina (0,5 my/kg/min.), adrenalina (0,1my/kg/min), dopamina (3my/kg/min.) y dobutamina (5my/kg/min.). Se utilizó como instrumento de registro de las RAM´s la Hoja Amarilla de CEVIFARE. Se procedió a la identificación de las RAM´s por su tipo, severidad y causalidad. El 83,33% de los pacientes presentaron RAM´s, siendo las más frecuentes: taquicardia (47,61%), palidez (23,80%), hipertensión (11,90%) y arritmias (7,14%). Todas las RAM´s fueron del tipo A, el 50% leves, 40% moderadas y 10% graves. El 100% de las RAM´s analizadas fueron probadas. Aunque los agonistas adrenérgicos estudiados resultaron ser seguros, la adrenalina tiene el riesgo de producir necrosis tisular distal, por lo cual el papel de la Enfermera(o) que practica la farmacovigilancia es prevenir o disminuir la posibilidad de aparición de RAM´s en los pacientes a su cuidado.

A descriptive study was made in 84 patients to determined adverse drugs reactions (DAR) during the IV treatment with some of the following adrenergic agonists: norepinephrine (0,5mu/kg/min), epinephrine (0.1mu/kg/min), dopamine (3mu/kg/min.) and dobutamine (5mu/kg/min). The Yellow Card of CEVIFARE was used as the instrument for registry of the DAR. DAR were analyzed by its type, severity and causality. 83.33% of the patients had DAR, being most frequent: tachycardia (47,61%), pallor (23,80%), hypertension (11,90%) and arrhythmias (7,14%). All the DAR were type A, mild 50%, moderate 40% and serious 10%. 100% of DAR analyzed were proved. Although the adrenergic agonists turned out to be safe, the epinephrine has the risk of producing distal necrosis, thus the Nursing role in practicing pharmacovigilance is to prevent or to diminish the possibility of appearance of DAR in the patients under her care.

Curcumin inhibits leukemia cell line HL_60 /ADR / 中国免疫学杂志

Abstract Objective:To explore the suppression of curcumin on leukemia cell line HL60/DAR. Methods: The suppression of curcumin onleukemia cell line HL60/DAR was studied by MTT;the apoptosis was studied by flow cytometric Annexin V/PI dual labeling technique and fluo-rescence microscope;the change in apoptosis related gene bcl-2 was studied by flow cytometry.Results: CUrcumin suppressed the growth ofHL60/DAR obviously IC50 were 8.94,5.2l,3.82 ?g/ml for 24,48,72 h respectively. Curcumin induced Hl60/DAR cells to apoptosisdeath. CUrcumin suppressed the expression of bcl-2. Conclusion: Curcumin can suppress the growth of HL60/DAR cells.